Thank you for your interest in participating in the
2018 Healthy Youth Survey (HYS)!

Please complete one online
registration form per school.
Upon completion, a registration confirmation email with the
information you provided will be sent to you, the Principal, the
Survey Coordinator and the Back-up Survey Coordinator. You
cannot print or save responses.

* Please note that survey administration must be conducted in a
standardized manner in all relevant classrooms to ensure that
student participation is voluntary and anonymous, to protect the
rights of students and parents, and to ensure that the data
collected are of the highest possible integrity.

Your Contact Information

This online registration is being completed by:

Your Name:

School or Agency:

Email Address:

Confirm Email Address:

Phone Number:

Register a School

Grandview High School

Does this school want to participate in the 2018 HYS?

By selecting "Yes", you agree to administer the 2018 HYS
and follow all of the required procedures.

Yes, we want to participate in the 2018 HYS.

No, we do not wish to participate.

School Information

Please provide the school's shipping information
(The person and the address you want the survey
questionnaires to be sent)

School SHIPPING Address (NO PO BOXES please):

To whose attention should the surveys be sent:

Location/agency where surveys should be sent:

Street address of this location:

City/Town:

Zip Code:

Please provide contact information for the school's Principal.

Title:

Name:

Email Address:

Confirm Email Address:

Phone Number:

Participation Agreement

By registering to participate in the HYS 2018, I
agree that this school will follow all survey requirements
and instructions:

(please check ALL of the requirements)

Administer the survey during the weeks of October 8-19, 2018

Return the survey materials no later than October 26, 2018

Ensure that the school's survey coordinator completes online training by September 17, 2018

If there are any changes to your registration
information - number of students taking the survey,
changes in the survey coordinator or principal's contact
information, etc., changes will be made online
via the link sent in your confirmation email.

I agree to notify parents about the survey with the
approved survey notification letter by September 24,
2018:

(please check AT LEAST ONE method of notification)

Mailing the letter home, or send it with the packet of forms/information at the beginning of the school year.

Sending the letter home with a packet of forms and information with students.

Emailing the letter to parents using the email notification requirements.

Automatic calls (robocalls) to parents using the robocall notification requirements.

I agree to notify students about the survey with the
approved survey notification letter by September 24,
2018:

(please check BOTH notification methods)

Posting the survey notification letter in a common school area.

Announcing the survey during a school assembly or in the classrooms where it will be administered.

I agree to VERIFY online that parents and students have been
properly notified by September 24th using the link I will be
emailed. Survey questionnaires WILL NOT BE SHIPPED until
online verification is complete.

I agree to verify online.

Web Address

What is the web address to the school's web site where
2018 HYS information and survey notification letter
will be posted?

Web Address:

Survey Coordination

Primary Survey Coordinator

Please provide the name of the person coordinating the
survey administration for the school. The surveys and
administration materials will be sent to this person.

Coordinator Name:

School or Agency:

Position:

Email Address:

Confirm Email Address:

Phone Number:

Back-Up Survey Coordinator

Please provide the name of the person coordinating the
survey administration for the school. The surveys and
administration materials will be sent to this person.

Coordinator Name:

School or Agency:

Position:

Email Address:

Confirm Email Address:

Phone Number:

Student and Classroom Information

How many students do you expect to be enrolled in each grade
level in Fall 2018?

Please note that we need this information to provide you
with enough copies of the survey for each student and enough
administration packets for each classroom. It
is very important for these numbers to be as accurate as
possible.

Grade 6 students:

Grade 7 students:

Grade 8 students:

Grade 9 students:

Grade 10 students:

Grade 11 students:

Grade 12 students:

How many classrooms do you expect to have in those grades?

Please estimate the number of classrooms or settings the survey will be given.

Number of Classrooms:

Reports of Results

Do you want a report of the results?

Reports of results will be generated for schools with 15 or
more valid completed surveys in a given grade level, unless
otherwise indicated here. Reports will be sent to the
district superintendent.

Yes, please generate results for this school.

No, please do not generate results for this school.

Submit Registration Form

Please hit SUBMIT to complete this school's registration form.

Thank You!

Decline Participation

To decline this school's registration for the Healthy Youth
Survey, please hit the SUBMIT button.

If you do wish to participate, hit the Previous button to go
back and start the registration form.